title: Does cesarean protect against fecal incontinence in primiparous women?
abstract: The objective of this study was to identify factors associated with new onset of postpartum fecal incontinence in primiparous women. A population-based study was conducted that surveyed all women delivering between 2002 and 2003 in Oregon. Factors associated with fecal incontinence were identified using logistic regression analysis. A total of 6,152 primiparous women completed the survey 3-6 months postpartum with 2,482 reporting a new onset of fecal incontinence (FI) after childbirth. Vaginal delivery was associated with a greater risk of FI compared to cesarean (odds ratio = 1.45; 95% confidence interval, 1.29 to 1.64). However, vaginal delivery without laceration or instrument assistance did not increase the risk of FI over cesarean. Being overweight (body mass index >/=30 kg/m(2)), pushing for greater than 2 h, and constipation were independently associated with postpartum FI (p < 0.05) regardless of route of delivery. This study provides important data to inform counseling and management of primiparous women.
authors.affiliation: Department of OB/GYN, Oregon Health & Science University, Portland, OR, USA. guisej@ohsu.edu
authors.forename: Jeanne-Marie
authors.initials: JM
authors.lastname: Guise
authors.forename: Sarah Hamilton
authors.initials: SH
authors.lastname: Boyles
authors.forename: Patricia
authors.initials: P
authors.lastname: Osterweil
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Karen B
authors.initials: KB
authors.lastname: Eden
authors.forename: Motomi
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section; D003248:Constipation / Q000150:complications; D003625:Data Collection; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D009772:Obstetrical Forceps / Q000009:adverse effects; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D012307:Risk Factors; D012720:Severity of Illness Index; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects